Intrinsic trigeminal nerve arteriovenous malformation: a rare cause of trigeminal neuralgia

Youness Et-tahir; Rahma Khabab; Aicha Merzem; Hasnaa Belgadir; Omar Amriss; Nadia Moussali; Naima El Benna

doi:10.5455/ajdi.20240603092547

Abstract
Intrinsic trigeminal nerve arteriovenous malformation is an exceptional cause of trigeminal neuralgia.
Imaging is not only important for visualising the nidus, but should also precise feeding arteries and draining veins, which are very variable in this location.
Magnetic resonance imaging provides the spatial resolution required to show the relation of the nidus with the trigeminal nerve, by using adapted sequences for vascular and neurological structures assessment.
Digital subtraction angiography remains the gold-standard imaging technic for showing the angioarchitecture of the arteriovenous malformation, proving its superiority to computed tomography angiography.
In this article, we report the case of a 77 years-old woman with trigeminal neuralgia secondary to an intrinsic trigeminal nerve arteriovenous malformation with unusual venous drainage, diagnosed by an MRI of the cerebellopontine angle, with the assessment of its angioarchitecture on CTA.

Key words: Trigeminal neuralgia - Intrinsic trigeminal nerve malformation - Magnetic resonance imaging - Computed tomography angiography - Digital subtraction angiography